Hand assisted Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Diversion: Novel Surgical Technique

, Geun Soo Kong; , Se Il Jung

Original Article

The Korean Journal of Urological Oncology 2005;3(1):39-45.
Published online June 1, 2005.

새로 고안된 손을 이용한 복강경하 근치적 방광적출술 및 체외 회장도관술

공근수, 정세일

동아대학교 의과대학 비뇨기과학교실

Hand assisted Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Diversion: Novel Surgical Technique

Geun Soo Kong , Se Il Jung

Department of Urology, Dong-A University School of Medicine, Busan, Korea

Correspondence: Se Il Jung

Abstract

Purpose
We present our experience performing hand-assisted laparoscopic radical cystectomy(HALRC) and evaluate the feasibility and potential benifits of this operation technique. Materials and Methods: Between January 2004 and June 2004, hand assisted radical cystectomy was performed on 3 patients with clinically organ confined bladder cancer. We performed a radical cystectomy and removing the specimen through the hand port site. The ileal loop urinary diversion was constructed by pulling the small bowel through the hand port incision. We made a stoma and through a port site and a drain was placed through a port site, also. The incision was closed in the standard fashion. Results: The hand-assisted laparoscopic radical cystectomy for bladder cancer was successfully performed in 3 patients. Operative time was about 7 hours and estimated blood loss was 500cc. All surgical margins were negative. The patients can ambulate on postoperative day 2 and resumed oral intake on postoperative day 3. Drain tube and ureteral catheter was removed on postoperative day 7 and 8. He did not have any complication and discharged from the hospital on postoperative day 8. Conclusions: Hand-assisted laparoscopic radical cystectomy is feasible, safe and minimally invasive procedure with a high primary success rate and reduce morbidity. (Korean J Uro-Oncol 2005;3:39-45)

Key Words: HALRC, Bladder tumor, Surgical technique